Apparatus for indirect transfusion and venoclysis



S p 10, 0- E. A. RAvENscRoFT El AL 2,214,260

APPARATUS FOR INDIRECT TRANSFUS ION AND VENOCLYSIS Filed Aug. 3, 1939 3 f ZZzzdamABaaemC foberzllforaan Patented Sept. 10, 1940 UNITED STATES PATENT OFFICE k ,214,260 APPARATUS FOR- INDIRECT TRANSFUSION.

AND VENOCLYSIS- of Illinois Application August a, 1939, Serial No. 288,150

4 Claims. (o1. mar-214) Thepresent invention relates to apparatus for indirect transfusion and venoclysis. More particularly, the present invention relates to apparatus including an improved container cap for 5 withdrawing blood andfor the intravenous in-.

jection of the same or other sterile liquids or mixtures thereof.

Many types of apparatus for indirect transfusion and for venoclysis have been suggested heretofbre.- Prior apparatus, however, has been found by the medical profession to'be crude or complex and to be generally unsatisfactory. The art has long desired a simple apparatus that I would serve for withdrawing blood from a donor as well as serve later for'intravenous injection into a patient.

. The principal object of our invention is to provide a practical apparatus for indirect transfusion and venoclysis free from the disadvantr ges found in apparatus available heretofore.

Another object of our invention is to provide a simple and improved cap adaptable for use in both indirect transfusion and venoclysis apparatus.

25 Other objects of the invention will be apparent from the following description.

Reference is made to a co-pending application oi! Edward A. Ravenscroft, Serial No. 73,862 filed April 11, 1936, directed to Apparatus for venoclysis in which the air inlet conduit of the container, due to a special nipple arrangement, is provided with a loop extending below the outlet nipple,.and .to a co-pending application of Ed-- ward A. Ravenscroft, Serial No. 174,535, filed November 15, 1937, directed to Apparatus for venoclysis", in which the air inlet is provided with a special type one-way valve. The present invention is based upon the discovery of a new and improved cap for the container and one-way check valve which may be used for indirect transfusion as well as venoclysis.

III the accompanying drawing forming a of the specification Flgfi is a longitudinal section through a container and cap provided with a suction bulb arranged for withdrawing blood for indirect transfusion.

Fig. 2 is a side elevation of the same container and cap arranged for' intravenous injection of 60 blood or for venoclysis.

Part

Fig. 3 is an enlarged longitudinal section,

56 Fig.4 is an enlarged longitudinal section showlustrated in Fig. 1.

ing a dripper-filter for intravenous injection of blood.

Fig. 5 is an enlarged fragmentary section taken on line 5.5 of Fig. 1, showing the inner orupper end of an extension tube that is inserted into the cap when withdrawingblood for indirect trans-' fusion.

Fig. 6 is a longitudinal sectionof a modified form of check valve element which may be substituted for that shown in Fig. 3.

Fig. 7 is a cross section taken on the line 1-1 of Fig. 6.

Referring to the drawing, a glass bottle or flask [0 serves as the container for the blood or other sterile liquids. In indirect transfusion for withdrawing blood, the container i0 is upright, and the cap is provided with a suction bulb ll, as il- In intravgznous injection or venoclysis, the container is supported. in an inverted position, and the cap is equipped with a check valve element such as 4 4 (Figs. 2. and 3) or 44' (Figs.6 and'7). r v

The container cap, designated as a whole by 29, and preferably made of molded resinous material,

shown in upright positionin Fig. 1, in 'which' position it transfers blood from the donor to the bottle l0, and in inverted position in Figs. 2 and 3, in which position it transfers the contents of the bottle ill to the donee or patient undergoing the transfusion. It'comprises two integral limbs 2| and 22 relatively ofiset both lengthwise and -sidewise and chambered and bored as follows:

3| of an inclined nipple '32. .The open end of limb 22 is externally threaded to receive a cover 30 for closing the chamber 22, a gasket 33 being inserted between the cover 30 and the end of the limb to insure a liquid tightjoint. The limb 2|- is formed with a. somewhat smaller chamber 2i, that communicates with a diametrically enlarged and internally threaded socket 2|" .that' receives the threaded neck of the bottle lfl a gasket 33' being interposed between the end of the bottle neck and an annular shoulder 23 at the inner end of the socket 2| to insure a liquid tight joint. With the closed upper end of chamber 2| communicates the bore. 21' of an inclined nipple 28 that extends in an opposite direction 'to the nipple 32 and is substantially parallel to the latter. In a partition wall 24 that is common toboth limbs of the cap is a straight bore 25 that forms a flow duct between the two chambers. The provision of the removablecover 30 facilitates thorough cleaning of-the chambers and ducts after and passageway 21 serves as the blood inlet duct and the chamber 2| form a generally N-shaped" duct in the cap, with the opposite ends of which the bores of the nipples 32 and 28 respectively communicate.

For withdrawing blood for indirect transfusion the apparatus is arranged asshown in Fig. 1. In this arrangement, passageway 3| serves as the air outlet duct from the cap and container to the container. Suction bulb l|, provided with the ordinary ball check valves 35 and 3B, is attached to nipple 32 and serves as a means for withdrawing air from the container. The lowering of the pressure in the container facilitates the flow of blood from the doner; The inlet nipple 28 connects by means of a conduit tube.

circumferential bead 4| on the container, which bead holds the container in place. The containerv for use in both indirect transfusion and venoclysis may be provided with graduated markings 42 for measuring liquid 43. In this arrangement passageway 21 serves as the liquid outlet aperture and passageway 3 serves as the air inlet aperture. A check valve element designated as a whole by 44 (Fig. 3) comprising a molded tubular body portion 45 of rubber containing porous air filtering material 46, and a rubber slit diaphragm valve 41 extending across the'bore of the body is attached to nipple 32 and serves as an air inlet as the liquid drains from the container. When using the apparatus for venoclysis or intravenous injection the bulb ii is removed. The outlet nipple 28 connects by means of conduit d8, dripper-filter 49 and conduit 58 to needle 5i. Dripper-filter 18 (Fig. 4) comprises an upper body 52 and a lower body 53 held together by a rubber sealing sleeve 54, the upper and lower body sections being provided with nipples 55 and 56 which engage tubes 48 and 58 respectively, as illustrated in Fig. 2. The upper nipple is provided with a short drip tube 51 located within the upper body, the drip tube being of aid in judging the speed of flow of fluid from the container to the patient. The fiow oi the injection fiuid may be controlled by the usual adjustable pinch clamp not shown. The blood filter is provided with screen gauge 58 and is used as a precaution tobe sure that the blood going to the patient is free from clots.

In the operation of the apparatus for indirect transfusion, the apparatus is first arranged as .shown in Fig. 1. In withdrawing blood, the operator first opens a sterile ampoule of sodium citrate solution or other anti-coagulation solution and draws the required amount of thissolution into the container by means of pumping on the rubber suction bulb. The needle (not shown) is then inserted into the donors veins with sterile precautions in the usual manner. The blood flows from the donor through the needle, conduit 31, passageway 21 and nipple 28, chamber 2| and extension tube 34, and into the container. During this operation the container is preferably grasped in one hand in such a manner that the bulb II can be squeezed witl" two fingers while holding the container with the thumb and other fingers. Held in this manner, it is easy to shake the container or flask so as to swirl the incoming blood around and "allow for proper admixture with the citrate solution in order to prevent possible coagulation. As previously mentioned, tube 34 is used to direct the flow of blood away from the side of the flask or container where it might possibly coagulate before reaching the main mass of blood in the flask below. Having completed the removal of blood from the donor, the flask with associated apparatus is then taken to the bedside of the patient to receive the blood, or it may be stored according to well established practice until needed.

To administer the blood to the patient, the extension .tube 34 is removed unless there is enough blood in container NJ to make removal of tube 34 unnecessary and the suction bulb is replaced by the check valve element, as shown in Fig. 2. The removal of tube- 34 necessitates the removal of the cap, and, to prevent possible contamination of the blood in the container by impurities in the air, should the cap remain separated from the container for any appreciable length of time, a plug of cotton treated with a sterilizing medium is temporarily inserted in the neck of the container. If check valve element 44 is used, the air passes through the filtering material 46, rubber slit valve 41, passageway 3| of nipple 32, chamber 22', and duct 25 into the container as the sterile liquid flows out of the container through chamber 2 I, passageway 21 of nipple 28, conduit 48, filter 49, conduit 50, needle 5|, and into the patient. From the above it will be apparent that the improved cap may be used for withdrawing blood, or injecting blood in inwith the passageway 3| of nipple 32 and functioning as a valve or stopper for said passageway when the body 59 is pushed downwardly on the nipple as far as it will go. In this position the annular outer end of the nipple also closes the lower ends of the air ducts 6|, so that there is a double seal against the escape of liquid. When later the administration to "the patient begins, the valve body 59 is drawn outwardly to the position shown in Fig. 6, and this permits inflow of air to replace the liquid drawn ofi.

When the check valve 44 is used, the rubber slit valve 41 prevents the liquid from flowing out of the air inlet when the container is first inverted and before a partial vacuum is created therein by the initial discharge of the contents of the container through the venoclysis tubing. As soon as 75 established, the partial vacuum opens the rubber slit valve and allows an even, uniform stream of air or air bubbles :to flow into the container as the latter empties.

When the check valve element 44' is used, be-

fore inverting the container the valve body 59 amount of porous filtering material 46 such as sterilized cotton or the like.

p Our new apparatus is compact, the new cap and check valve element making it unnecessary in venoclysis to use long tubing leading to an air 5 inlet or filter elevated above the liquid in the container. Our apparatus in addition, makes it unnecessary to insert glass. air inlet tubes from the cap to the bottom of the container. The use practice we have found this form of check valve somewhat more reliable than the rubber slit form, although the latter, when accurately made, gives satisfactory results, and has the advantage of being entirely automatic.

It is important to note that'the chamber 22' is of. substantial size and that this chamber in the inverted position of the cap and container, is filled with liquid before any of the latter can pass out through nipple 32. Because of this arrangement, the cap functions satisfactorily for the administration of liquid to the patient without any check valve attached to nipple 32 after 30 the partial vacuum is initially established in the container. .specifically, as air. enters the container through conduit 25, it reduces somewhat the'par'tial vacuum and ailowsagnuid to tlow down through conduit 25 and p tially fill the 35 vacuum in the container'and theback flow of liquid into the chamber 22 ceases. As the contents of the container continue to discharge throughout outlet nipple 28 and attached-venoclysis tubing the vacuum increases in the container and .the liquid trapped in the chamber 22'-gradually flows up through conduit 25 until chamber 22.. In so doingit cre tes additionalmore air is admitted and then the cycle repeats.

.Because of this unique function of chamber 22' we have, in our apparatus, retained the-ease of making multiple container.hook-ups for continuous venoclysis. For example, assuming-the" first container to begin operation and the liquid, therein flowing into the patients veins, the prowith a cap 20 attached as shown in Fig. 1 is 'first brought up adjacent the first container. The check valve element 44 or 44' is then removed from the inlet nipple of the first container and 55 placed in a corresponding position (on nipple 32) on the cap of the second'container. The outlet nipple 28 communicating with chamber 2| of the cap of the second container is thencon nected by means of a conduit to the inlet nipple,

cedure would 'be as follows: The, second pontainer inwardly bowed diaphragm provided "with a slit;

70 molded therein. The bore of this check valve element is preferably provided with an annular restriction or ledge 63 which protectsvalve'll and keeps it out. of contact with nipple-32. The

"bore of thecheck valve-element'should be large.

enough at'it's outer end to accommodate a small of such. tubes has long been recognized as unsat- 10 isfactory due to the leakage of the liquid there- 'from when the container is first inverted and also due tothe ease witnwhich glass delivery tubes slip from the cap resulting in a loss of liquid. An additional advaritage'of the present 15 apparatus is that .the rubber in contact with the solution is reduced to a minimum.

' It will be understood that our invention is not limited to the exact preferred embodiments above described, but detail chan es in structure and arraYngement' may be resorted to within the scope and coverage of the claims; I

1. In an apparatus for indirecttransfusion and venoclysis, the combination with a container cap comprising a body having a lower open end internally threaded to screw onto the threaded neck of a bottle container, said body formed with a generally N-shaped duct, and having a nipple communicating with one end of said duet adapted to 30"- receive a tube leading froma blood donor in the upright position of said cap and container and a tube leading to a donee or patient 'in the in verted position of said cap and container, and having, another nipple communicating-with the other end of said duct'adapted to receive a suc tion member in the; upright position 011 said cap and container, of a check valve element adapted to be removarllijli mounted on said last named nipple and co i leakage of the liquid contents of the containerv through the cap when the container and cap are inverted and to later admit air to the container to replace liquid drawn on from the latter, said check valve element comprising a tubular rubber body telescopingly engaged with said last named nipple and having a'rubber slit diaphragm valve extending across its bore, said'valve opening inwardly u' der air pressure and closing outwardly under pre me of the liquidin the container.

2. In an apparatus for indirect transfusion and venoclysis, the "combination with. a container cap comprising abody having a lower open end internally threaded to screw onto the threaded neck of a bottle container,- said body formedwwith a generally N-shaped duct, and having a nipple communicating with one end of said duct adapted to receive a tube leading from a; blood donor in the upright position of said cap and container and atube leading to a don'ee or patient in the inverted position of said cap'and container, and having another nipple communicating with the other end of said .duct' adapted to'receive a-suction member in the up rightpositipn of said cap and container, of a, .65 check valve element adapted to be removably mounted on said. last named nipple and containing a. valve operative to'block leakage oithe vliquid contents or the container through the cap when the containerand cap are-inverted and to later admit air to the'containerto replace liquid drawn 011 from the latter, said check valve-element comprising aytubular body telesco'pingly engaged} with said'last named-nipple and .hav.-"

ins abridge extending across'its bore, me bridge is ning a valve operative to block 4 having an air duct extending therethrough and a tapered valve on its inner side adapted to plug the nipple passageway when said body is pushed inwardly over the nipple far enough to bring said valve into contact with the free end of the nipple.

3. A container cap of the type described adapted for use in indirect transfusion and venoclysis, comprising a one-piece body of molded resinous material, comprising limbs relatively ofiset both lengthwise and sidewise and having a common partition wall, the upper of said limbs having a chamber with an open upper end normally closed by a cover and an inclined nipple communicating with the lower portion of said chamber, and the lower of said limbs having a :hamber with an open lower end opening into an internally threaded socket adapted to engage with the threaded neck of the container and an oppositely directed inclined nipple communicating with the upper portion of said last named chamber, and said partition wall having a duct connecting said chambers, and a removable extension tube communicating at its upper end with said last named chamber and of suflicient length to-depend through the neck of the container; said first named nipple being adapted to receive a suction bulb in the uprightposition of said cap and container and a check valve to admit air to the container but block leakage of liquid from the container in the inverted position of said cap and container, and said last named nipple being adapted to receive a tube leading from a blood donor in the upright position of said cap and container and a tube leading to a donee or patient in the inverted position of said cap and container.

itially established in the container.

ternally threaded socket adapted to engage with r the threaded neck of the container and an upwardly inclined nipple communicating with the upper portion of said last named chamber, and said partition wall having a duct connecting said chambers; said first named nipple being adapted to receive a suction bulb in the upright position of said cap and container .and serving to admit air to the container in the inverted position of said cap and container, and said last named nipple being adapted to receive a tube leading from a source of liquid in the upright position of said cap and container and a tube leading toa patient in the inverted position of said cap-"and -container; said first named chamber being of substantial size and adapted to be filled with liquid before any liquid can pass out through its nipple, whereby the cap may function satisfactorily for the administration of liquid to the patient without any check valve applied to said firstnamed nipple after a partial vacuum is in-' EDWARD. A. RAVENSCROF'I. ROBERT E. JORDAN; 

